Connection Between Mental Health And Substance Use Disorders

It’s no secret that there is a strong connection between mental health and addiction. Exploring the different layers and interactions between co-occurring mental health and substance use disorders can be enlightening, both for those living with poor mental health and addiction and for their loved ones.

Poor mental health and substance abuse/addiction are twin health issues linked not only to each other, but also to common underlying factors like trauma, genetics, and inequality. Understanding the deep connections between mental illness and substance use disorder, including the ways that they interact, is important, as is understanding the need for combined treatment approaches able to address both of these conditions when they occur together.

Mental Health & Substance Abuse: Facts And Figures

In the United States today, the connection between mental health and addiction is clear.

According to various government statistics, including SAMHSA’s 2022 National Survey on Drug Use and Health:

  • around half (46.2%) of adults with a substance use disorder (SUD) also have some form of mental illness, and a significant portion (36.3%) of adults who have a mental illness also have some form of SUD
  • over 60% of adolescents in community-based substance use disorder treatment programs meet the criteria for some form of mental illness
  • over 21.5 million Americans have both an SUD and mental health condition, and 7.4 million of those have both an SUD and a serious mental illness (SMI)
  • each year, nearly one-third of adults experience an SUD, mental illness, or both
  • American men are more likely to use illicit drugs and abuse alcohol or other substances than women, have double the rate of substance dependence, and commit suicide around four times more often
  • 43% of people receiving SUD treatment for prescription painkiller abuse have a diagnosis or symptoms of mental illness, especially depression and anxiety disorders
  • around 40% of deaths by suicide involve alcohol use, 30% involve narcotic use, and 21% involve cannabis use

However, to really understand the ways that mental health and substance abuse interact, we need to consider three specific dynamics outlined by the National Institute of Mental Health.

Substance Abuse Contributes To Mental Health Problems

When a person has a substance use disorder, their use of drugs or alcohol has become compulsive and unmanageable. What may have started as social use, experimentation, or self-medication has grown into something else, and something that they can’t easily stop, even if they want to and even if they are aware that the drugs or drinking is harming their relationships, finances, health, and stability.

People who have experienced this often recall their addiction as a sort of hunger. And as it grows, that hunger, that need, becomes the most important thing in their life; more important than food, rest, responsibilities, shelter, or safety.

While many different substances can produce some degree of psychological dependence, the worst culprits are drugs like opioids/painkillers (e.g., oxycodone, heroin, fentanyl, etc.), amphetamines and methamphetamine, cocaine, alcohol, and benzodiazepines (e.g., diazepam, alprazolam, clonazepam, etc.). These substances not only change the body’s internal chemistry, producing withdrawal pains and illness when a person tries to quit, but also change the structure of the brain, shifting a person’s personality and behavior.

These changes can also have a devastating impact on a person’s mental health, regardless of whether or not they already have some form of mental illness.

Examples include:

  • alcohol abuse, which is strongly linked to the development of depression and anxiety disorders as well as dementia and other memory and personality problems
  • stimulant abuse, which can produce lasting symptoms of psychosis including confusion, hallucinations, delusions, and paranoia
  • prolonged opioid use, which can impair decision-making and stress management
  • prolonged benzodiazepine use, which can lead to impaired thinking, memory loss, anxiety, depression, and other lasting negative effects

Because of its effects on brain structure, function, and behavior, substance abuse is commonly referenced as one of the greatest risk factors for the development of SMIs. It is also known to aggravate the symptoms of existing mental health disorders ranging from post-traumatic stress disorder (PTSD) to obsessive-compulsive disorder (OCD), schizophrenia, bipolar disorder, and many others.

Poor Mental Health Prompts Substance Abuse

Many people who live with a mental health disorder like panic disorder or another anxiety disorder, depression, bipolar disorder, schizophrenia, PTSD, or a personality disorder will never be diagnosed.
A person struggling with undiagnosed mental illness may battle against unwanted thoughts, emotional states, or impulsive reactions. They may see or hear things that aren’t there, believe things that aren’t based in reality, or behave in strange or alarming ways. They may have trouble even just leaving their home.

These symptoms can make it hard to build relationships, thrive at school or in the workplace, or simply feel confident and optimistic. But both mild and severe forms of mental illness are treatable and manageable. In fact, a wide range of treatment options are available for people to explore, including different combinations of medication, therapy, and self-help.

However, many people instead turn to drugs and alcohol, using the intoxicating effects of these substances for relief or escape from the distress of their day-to-day reality. Self-medicating is never an effective long-term solution, and the more drugs and alcohol are misused, the higher the risk a person will make their mental health struggles worse, damage their physical health, and become dependent or develop a full-fledged SUD as well.

Underlying Causes Of Mental Illness And Substance Use

Evidence also points to a relationship between serious mental illnesses and substance abuse that goes deeper than side effects or self-medication. In fact, these two types of conditions are thought to share a variety of underlying causes, making it much more likely that people who struggle with poor mental health or an SMI will also tend to misuse drugs or alcohol during their lives.

These common factors are thought to include:

  • genetic predispositions revealed by a family history of substance abuse and mental health issues
  • certain elements of brain structure and personality
  • childhood trauma (e.g., abuse, neglect, or isolation)
  • financial insecurity or poverty
  • recent major life events like a serious injury, disability, job loss, divorce, or the death of a loved one
  • untreated common childhood mental health concerns, especially attention-deficit/hyperactivity disorder (ADHD) and bipolar disorder

While some of these factors are unavoidable, others can and should be addressed as early as possible. By providing proactive mental health treatment and other forms of intervention, caregivers, loved ones, and medical professionals can help those at risk of experiencing mental health events and substance abuse avoid them.

Otherwise, the longer a person’s substance abuse and mental illness continue unmanaged, the worse the co-occurring disorders may become.

Dual Diagnosis Treatment Works

Dual diagnosis treatment programs, like those available at Spring Hill Recovery Center, are designed to provide detailed and personalized solutions for managing both substance use and mental health disorders like depression, panic disorder, ADHD, PTSD, OCD, bipolar disorder, or schizophrenia. And this approach works.

During treatment, clients may receive psychiatric medications or have their current medications adjusted, participate in individual therapy sessions, work on new coping skills and strategies to better manage their symptoms, and spend time with others who are also working through the same issues. Treatment providers can also help clients deal with the effects of drug or alcohol withdrawal and the cravings and compulsions that come with it, while also monitoring their condition regularly and establishing a long-term aftercare plan.

Get Help Today

We know that the connection between mental health and addiction runs deep. Only by considering every facet of a client’s psychological, behavioral, and social needs can treatment professionals make sure that there are no pitfalls left in the road to recovery and that people in need of dual diagnosis care aren’t sent out on their own with the tools to address only one disorder, while another continues to throw them off balance.

If you or someone you love has been struggling with drug abuse or alcohol abuse, complicated by unmet mental health needs, please consider finding a dual diagnosis treatment program.

At Spring Hill, our treatment staff offer a holistic, multidisciplinary approach to dual diagnosis treatment, with services available for all forms of SUD as well as conditions like anxiety disorders, depression, acute stress disorder, bipolar disorder, adult ADHD, and many others.

To learn more about our services, our campus, or our care team, or for answers to questions about your insurance coverage, please reach out to us today.

  1. National Institute of Mental Health (NIMH) - Substance Use and Co-Occurring Mental Disorders,a%20form%20of%20self%2Dmedication.
  2. National Institute on Drug Abuse (NIDA) - Part 1: The Connection Between Substance Use Disorders and Mental Illness
  3. Substance Abuse and Mental Health Services Administration (SAMHSA) - Mental Health and Substance Use Co-Occurring Disorders
  4. Substance Abuse and Mental Health Services Administration (SAMHSA) - Results from the 2022 National Survey on Drug Use and Health: Graphics from the Key Findings Report (
  5. U.S. Centers for Disease Control and Prevention (CDC) - National Violent Death Reporting System, 18 States, 2014

Written by Spring Hill Recovery Editorial Team

Published on: July 3, 2024

© 2024 Spring Hill Recovery | All Rights Reserved

* This page does not provide medical advice.

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